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This article is part of the supplement: The evolution of anti-TNF therapy in rheumatic disease: experience, insights and advances

Highly Accessed Review

Infliximab: 12 years of experience

Josef S Smolen12* and Paul Emery3

  • * Corresponding author: Josef S Smolen

Author Affiliations

1 Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria

2 2nd Department of Medicine, Hietzing Hospital, Waehringer Guertel 18-20, A-1090 Vienna, Austria

3 Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds; NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, Leeds, Chapel Town Road, Leeds LS7 4RX, UK

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Arthritis Research & Therapy 2011, 13(Suppl 1):S2  doi:10.1186/1478-6354-13-S1-S2

Published: 25 May 2011

Abstract

Rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are immune-mediated conditions that share an inflammatory mechanism fuelled by excessive cytokines, particularly TNF. Control of inflammation and rapid suppression of cytokines are important in treating these diseases. With this understanding and the corresponding advent of TNF inhibitors, RA patients, AS patients and PsA patients have found more choices than ever before and have greater hope of sustained relief. As a widely used TNF inhibitor, infliximab has a deep and established record of efficacy and safety data. Extensive evidence - from randomised controlled clinical trials, large registries and postmarketing surveillance studies - shows that infliximab effectively treats the signs and symptoms, provides rapid and prolonged suppression of inflammation, prevents radiologically observable disease progression and offers an acceptable safety profile in RA, AS and PsA. In very recent studies, investigators have observed drug-free remission in some patients. Additionally, infliximab may interfere with rapidly progressing disease in RA by early addition to methotrexate in patients with signs of an aggressive course. Finally, infliximab has been shown to reduce PsA clinical manifestations such as nail involvement. With our current understanding, substantial data and increasing confidence regarding use in practice, infliximab can be considered a well-known drug in our continued campaign against inflammatory rheumatic diseases.